Hemostasis
A general term for any process that stops bleeding
Coagulation
When hemostasis occurs because of the physiological clotting of blood, it is called...
Clots
Insoluble elements of blood, including cells, fibrin threads, that have chemically separated from the liquid component of the blood are called...
Thrombus
The technical term for a blood clot is...
Embolus
A thrombus that is not stationary but moves through blood vessels is called...
Anticoagulants
Substances that inhibit the action of or formation of clotting factors and prevent clot formation
Antiplatelet drugs
Substances that inhibit platelet aggregation and prevent platelet plugs
Thrombolytic drugs
Substances that lyse (break down) existing clots
Hemostatic agents
Substances that promote blood coagulation/arrests the flow of blood
Antifibrinolytic drugs
Hemostatic drugs are also known as...
False
T/F Anticoagulants have an effect on clots that have already formed
Clot formation (thrombus) and dislodged clots (embolus)
Anticoagulants are used prophylactically to prevent which 2 events?
Coagulation cascade
The coagulation system is known as ________ ________ because each activated clotting factor serves as a catalyst that amplifies the next reaction
Fibrin
The result of the coagulation system is _______, a clot forming substance
Intrinsic and Extrinsic
The coagulation system is typically divided into two pathways known as....
Extrinsic
Which pathway is initiated when blood vessels are damaged by penetration from the outside which releases thromboplastin and activates factors VII and X?
Intrinsic
Which pathway is initiated when factor XII comes into contact with exposed collagen on the inside of damaged blood vessels?
The drug/agent
The mechanism of action of anticoagulants vary depending on what?
True
T/F anticoagulants work on different points of the clotting cascade
heparin, low-molecular-weight heparins, warfarin
3 examples of anticoagulants are...
Thromboembolic events
The prevention of clot formation also prevents complications that involve a thrombus becoming an embolus and causing an adverse cardiovascular event known as....
Myocardial infarction
An embolus that lodges in the coronary artery is known as a....
Cerebrovascular accident (stroke)
An embolus that obstructs a brain vessel causes a...
Pulmonary embolus
An embolus that travels to the lungs is called a...
Deep vein thrombosis
An embolus that travels to a vein in the leg is called...
Myocardial infarction, Unstable angina, Atrial fibrillation, Indwelling devices, Major orthopedic surgery
Anticoagulants are used to prevent clot formation in 5 main settings:
Bleeding, nausea and vomiting, abdominal cramps, thrombocytopenia
The main side effects of anticoagulants include...
Increases
The risk of bleeding _______ (increases or decreases) with an increased dose of anticoagulants
Thrombocytopenia
the condition that occurs when the platelet count in your blood is too low
Activated Partial Thromboplastin Time (aPTT)
A screening test that helps evaluate a person's ability to appropriately form blood clots is...
seconds
The aPTT is measured in ______
therapeutic
The aPTT helps to keep medication in the ___________ range
Heparin
Which anticoagulant drug is monitored daily by aPTT?
Heparin
Which anticoagulant drug is given parenterally?
1 to 2
Heparin has a short half life of ____ to ____ hours
Protamine sulfate
The effects of heparin can be reversed by...
True
T/F SC doses of heparin should be given in areas of deep subcutaneous fat and sites should be rotated
the umbilicus, abdominal incisions, unhealed wounds
Subcutaneous doses of drugs should not be given within two inches of...
hematoma
SC injections should not be aspirated as it can cause the formation of a...
False
T/F SC injection sites should be massaged after the injection
bolus, IV infusion
IV doses of heparin may be given by ______ or ___________
Immediately
Anticoagulant effects of heparin are seen ___________ (immediately, 30 minutes later, 1 hour later)
Low-molecular-weight heparin
Enoxaparin and dalteparin are examples of what kind of anticoagulant drug?
more
Low-molecular-weight heparins have a _____ (more or less) predictable anticoagulant response
false
T/F low-molecular-weight heparins require constant aPTT monitoring
abdomen
low-molecular-weight heparins are given subcutaneously in the __________, rotating injections sites
International Normalization Ratio (INR)
the standard unit for reporting the clotting time of blood is
2.0 to 3.0
A standard INR for a client taking anticoagulants is ____ to _____
Warfarin sodium
Which anticoagulant drug is given orally?
INR
Warfarin sodium is monitored regularly by _____
vitamin k
What substance can be given if warfarin sodium toxicity occurs?
IM, IV, PO
Vitamin K can be given by which routes?
true
T/F Warfarin sodium may be started while the client is still on heparin until prothrombin times indicate adequate anticoagulation
Several days after
The therapeutic effect of warfarin sodium occurs __________ (immediately, 30 minutes after, one hour after, several days after)
Antiplatelet drugs
aspirin, dipyridamole (Aggrenox), Pentoxifylline (Trental), Clopidogrel (Plavix), and Ticlopidine (Ticlid) are all examples of what kind of drug?
Reduce
Antiplatelet agents ______ (increase or reduce) the risk of fatal and nonfatal strokes
False, they vary according to the agent
T/F the side effects for every antiplatelet drug is the same
overbleeding
The number one concern that nurses look for in a patient taking antiplatelet drugs is...
Nicotine
_________ causes vasoconstriction, which alters the effectiveness of antiplatelet agents
Older
streptokinase and urokinase are examples of ______ (older or newer) thrombolytic agents
Newer
Tissue plasminogen activator and Anisoylated plasminogen-streptokinase activator complex (APSAC) are examples of ________ (older or newer) thrombolytic agents
alteplase TPA, reteplase, tenecteplase
3 more examples of thrombolytic agents are...
fibrinolytic system
The system that breaks down blood clots is called the...
fibrinolytic
Step one of the mechanism of action of thrombolytic agents involves activating the ____________ system to break down the clot in the blood vessel quickly
plasminogen, plasmin
Step 2 of the mechanism of action of thrombolytic agents involves activating _________ to convert it to _________, which can digest fibrin and breaks down the thrombus
Coronary
The 3rd and final step in the mechanism of action of thrombolytic agents involves reestablishing blood flow to the heart muscle via the _________ arteries, preventing tissue destruction
Thrombolytic agents
Acute Myocardial Infarction, Arterial thrombolysis, Deep vein thrombosis, Occlusion of shunts or catheters, and a Pulmonary embolus are all indications for which drugs?
Bleeding, nausea and vomiting, hypotension, allergic reactions, dysrhythmias
The main side effects to watch for when using thrombolytic agents are...
Intracranial, internal, superificial
What are the 3 types of bleeding that can occur with the use of thrombolytic agents?
bleeding, redness, pain
What should be monitored in a client using thrombolytic agents intravenously?
Internal bleeding
Decreased BP, restlessness, and increased pulse are signs of...
Excessive/abnormal bleeding
Bleeding of gums while brushing teeth, unexplained nosebleeds, heavier menstrual bleeding, bloody or tarry stools, bloody urine or sputum, abdominal pain, vomiting blood are signs of...
Client education
Emphasizing the importance of regular lab testing, signs of abnormal bleeding, measures to prevent bruising, bleeding, or tissue injury, monitoring for signs of excessive bleeding, and wearing a medical alert bracelet, are all aspects of...
Vitamin K
tomatoes, dark leafy green vegetables, bananas, and fish are foods that are contraindicated in clients taking anticoagulants because they are high in what substance?